Not sure I understand you. This is something I found on the internet. I submitted the link here because I thought it might interest some HNers, and possible provoke some interesting discussion.
This isn't my form, nor is it a form I was being asked to complete. I'm not the person who took the screenshot, nor the person being asked to confirm my identity.
This is the way HN works - when people come across things they think the HN community might be interested in, or might like to discuss, they submit a link to it.
Or have I completely misunderstood? if you want to know more then you might ask the person mentioned in the screen-shot. here: